Abstinence rates among college cigarette smokers enrolled in a randomized clinical trial evaluating Quit and Win contests: The impact of concurrent hookah use

Abstract

Objective To examine baseline characteristics and biochemically verified 1-, 4-, and 6-month tobacco quit rates among college students enrolled in a Quit and Win cessation trial, comparing those who concurrently smoke both hookah and cigarettes with those who deny hookah use. Methods Analyses were conducted on data from 1,217 college students enrolled in a Quit and Win tobacco cessation randomized clinical trial from 2010–2012. Multivariable logistic regression (MLR) analyses examined group differences in baseline characteristics and cotinine verified 30-day abstinence at 1, 4, and 6-month follow-up, adjusting for baseline covariates. Results Participants smoked 11.5(±8.1) cigarettes per day on 28.5(±3.8) days/month, and 22% smoked hookah in the past 30 days. Hookah smokers (n=270) were more likely to be male (p<0.0001), younger (p<0.0001), report more binge drinking (p<0.0001) and score higher on impulsivity (p<0.001). MLR results indicate that hookah users, when compared to non-users, had a 36% decrease in odds of self-reported 30-day abstinence at 4-months (OR= 0.64, 95% CI=0.45–0.93, p=0.02) and a 63% decrease in odds in biochemically verified continuous abstinence at 6-months (OR = 0.37, CI=0.14–0.99, p=0.05). Conclusion College cigarette smokers who concurrently use hookah display several health risk factors and demonstrate lower short and long-term tobacco abstinence rates.

Expectancies for and use of e-cigarettes and hookah among young adult non-daily smokers

“…We recently reported that young adult cigarette smokers who had used hookah in the past month reported increased cigarette consumption six months later, whereas non-users of hookah reported no change (Doran, Godfrey, & Myers, 2015). Polytobacco use has also been associated with higher nicotine dependence, even among nondaily smokers (Timberlake, 2005, 2009), and greater difficulty quitting cigarettes (Thomas et al, 2015; Wetter et al, 2002). Overall, polytobacco use may increase nicotine intake, accelerating progression toward dependence and chronic, daily tobacco use.…”

Systematic review of interventions aimed at reducing hookah pipe use: Implications for practitioners and clinicians

“…The studies showed that the interventions were contextualised for these continents and settings. Of the 10 studies, 7 focused on the efficacy of the intervention, [27][28][29][30][31][32][33] 2 on the feasibility of the intervention, [34,35] and 1 on describing the intervention. [36] Fifty percent (n=5) of the studies were of randomised controlled design, 30% (n=3) pre-test and post-test design, and 20% (n=2) quasi-experimental design.…”

“…[27,29] The reasons for focusing on adolescents were that the period of adolescence has been identified as a higher risk factor for hookah pipe use than any other age group [29] and that smoking often starts during adolescence. [27] Some studies focused on adult smokers and included college or university students [30,33,35] and adults. [28,31,32,34,36] Table 2 describes each intervention in terms of the RE-AIM framework.…”

“…[31] Four studies made reference to their exclusion criteria, [29,31,32,34] which were mainly severe medical conditions and inability to understand consent procedures. The inclusion criteria included age, and that participants needed to have attended high school, [27,29] vocational school, [27] college or university [30,33,35] or the healthcare facility, [31,32] be current smokers who smoked either one cigarette or hookah pipe per day [34] or month, [30] be part of the US Air Force undergoing technical training, [28] have access to the internet [35] or have suspected pulmonary tuberculosis. [31] The total enrolment of the 10 interventions was 13 516 people.…”

“…[35,36] However, 8 of the 10 studies (80%) reported having met their objectives and displayed some degree of efficacy. [27][28][29][30][31][32][33][34] Table 3 describes how effective the interventions were. Interventions were effective because they enhanced the social skills needed to avoid the use of drugs and improved the self-efficacy of the participants.…”